Doctors Will Prescribe Branded Drugs for Food, Study Finds

Give a man a fish, and he'll eat for a day. Give a doctor a $20 fish dinner, and he'll prescribe your expensive brand-name drug.

Doctors make cheap dates, or so a study published Monday by JAMA Internal Medicine seems to suggest. Last month, ProPublica found that physicians who receive money from drug companies and medical-device-makers are more likely to prescribe brand-name drugs over virtually identical — but much cheaper — generic alternatives. The JAMA study affirms that research, finding that doctors who accept a single $20 meal from a pharmaceutical company are more likely to recommend branded drugs to their patients than those who never receive a freelunch.

The analysis focused on four drugs covered by Medicare part D: the cholesterol-lowering Crestor, the high-blood-pressure treatments Benicar and Bystolic, and the antidepressant Pristiq. Looking at the prescription habits of roughly 280,000 doctors who received industry-sponsored meals — which were worth less than $20 on average — the researchers found that doctors who accepted one free meal courtesy of Crestor were 18 percent more likely than other physicians to prescribe the brand-name drug over its low-cost alternative. For Benicar, Bystolic, and Pristiq, the increased probabilities were 52, 70, and 118 percent,respectively.

And the more meals a doctor received, the more likely he or she was to make Medicare pay for the more expensive drug. Doctors who received four meals courtesy of Allergan, the drugmaker behind Bystolic, were 540 percent more likely to prescribe the betablocker.

In a sense, the study’s findings aren’t too surprising — we’ve known that free food makes human beings more responsive to a sales pitch ever since the first homo sapiens went on a date in the African savanna. Still, the fact that doctors’ medical decisions can be influenced by such meager offerings testifies to the way corruption can take root at a level beneath awareness: It’s unlikely that any physician consciously decided to trade their professional integrity for one glorious night at OliveGarden.

“Any gifting creates a sense of obligation,” Arthur Caplan, who heads the ethics program at NYU’s Global Institute for Public Health, told Bloomberg. “Small gifts attach themselves as marketing reminders. You get a chance to give yourmessage.”

This insight appears just as relevant to the realm of politics. JAMA’s findings suggest that a politician can be corrupted by donors without ever intending to be: Exposure to a benefactor’s message — combined with our species’ innate inclination toward norms of reciprocity — may be enough to tilt thescales.

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THE FEED

1:28 p.m.

WhatsApp with that?

Jared Kushner, the president’s son-in-law and senior adviser, uses an unofficial online messaging service for official White House business, including with foreign contacts, his lawyer told the House Oversight Committee late last year.

The lawyer, Abbe Lowell, said he was not aware if Mr. Kushner had communicated classified information on the service, WhatsApp, and said that because he took screenshots of the communications and sent them to his official White House account or the National Security Council, his client was not in violation of federal records laws.

In a letter disclosing the information, the Democratic chairman of the House Oversight and Reform Committee said that he was investigating possible violations of the Presidential Records Act by members of the Trump administration, including Mr. Kushner and his wife, Ivanka Trump. He accused the White House of stonewalling his committee on information it had requested for months.

Sen. Joni Ernst (R-Iowa) on Thursday urged President Donald Trump to stop disparaging the late Sen. John McCain, calling the Vietnam war hero “a dear friend” and defending him against the president’s criticisms. …

Ernst’s remarks came during a town hall meeting at a high school in Adel, Iowa, where several attendees voiced anger about Trump’s attacks about McCain. One attendee described McCain as a “genuine war hero” and called Trump’s comments about McCain “cowardly.”

“I do not appreciate his tweets,” Ernst said, when pressed by the attendee why she didn’t previously speak out more forcefully. “John McCain is a dear friend of mine. So, no I don’t agree with President Trump and he does need to stop.”

As we anticipate the end of Mueller, signs of a wind-down:-SCO prosecutors bringing family into the office for visits-Staff carrying out boxes-Manafort sentenced, top prosecutor leaving-office of 16 attys down to 10-DC US Atty stepping up in cases-grand jury not seen in 2mo

For Boeing and other aircraft manufacturers, the practice of charging to upgrade a standard plane can be lucrative. Top airlines around the world must pay handsomely to have the jets they order fitted with customized add-ons.

Sometimes these optional features involve aesthetics or comfort, like premium seating, fancy lighting or extra bathrooms. But other features involve communication, navigation or safety systems, and are more fundamental to the plane’s operations.

Many airlines, especially low-cost carriers like Indonesia’s Lion Air, have opted not to buy them — and regulators don’t require them. Now, in the wake of the two deadly crashes involving the same jet model, Boeing will make one of those safety features standard as part of a fix to get the planes in the air again.

… Boeing’s optional safety features, in part, could have helped the pilots detect any erroneous readings. One of the optional upgrades, the angle of attack indicator, displays the readings of the two sensors. The other, called a disagree light, is activated if those sensors are at odds with one another.

Boeing will soon update the MCAS software, and will also make the disagree light standard on all new 737 Max planes, according to a person familiar with the changes, who spoke on condition of anonymity because they have not been made public. The angle of attack indicator will remain an option that airlines can buy.

Attorneys for New England Patriots owner Robert Kraft and more than a dozen other defendants charged in a Florida prostitution sting filed a motion to stop the public release of surveillance videos and other evidence taken by police.

Attorneys filed the motion Wednesday in Palm Beach County court. The State of Florida does not agree with the request, according to the filing.

In the motion, the attorneys asked the court to grant a protective order to safeguard the confidentiality of the materials seized from the Orchids of Asia Day Spa in Jupiter, and “in particular the videos, until further order of the court.”

Two years in, White House aides are dismayed to discover the president likes lobbing pointless, nasty attacks at people like George Conway and John McCain

But the saga has left even White House aides accustomed to a president who bucks convention feeling uncomfortable. While the controversies may have pushed aside some bad news, they also trampled on Trump’s Wednesday visit to an army tank manufacturing plant in swing state Ohio.

“For the most part, most people internally don’t want to touch this with a 10-foot pole,” said one former senior White House official. A current senior White House official said White House aides are making an effort “not to discuss it in polite company.” Another current White House official bemoaned the tawdry distraction. “It does not appear to be a great use of our time to talk about George Conway or dead John McCain. … Why are we doing this?

When Mr. Trump was running for president, he promised to personally stop American companies from shutting down factories and moving plants abroad, warning that he would punish them with public backlash and higher taxes. Many companies scrambled to respond to his Twitter attacks, announcing jobs and investments in the United States — several of which never materialized.

But despite Mr. Trump’s efforts to compel companies to build and hire, they appear to be increasingly prioritizing their balance sheets over political backlash.

“I don’t think there’s as much fear,” said Gene Grabowski, who specializes in crisis communications for the public relations firm Kglobal. “At first it was a shock to the system, but now we’ve all adjusted. We take it in stride, and I think that’s what the business community is doing.”

There’s no specific stipulation that Milo must be heard, so it could be worse

President Trump is expected to issue an executive order Thursday directing federal agencies to tie research and education grants made to colleges and universities to more aggressive enforcement of the First Amendment, according to a draft of the order viewed by The Wall Street Journal.

The order instructs agencies including the Departments of Education, Health and Human Services and Defense to ensure that public educational institutions comply with the First Amendment, and that private institutions live up to their own stated free-speech standards.

The order falls short of what some university officials feared would be more sweeping or specific measures; it doesn’t prescribe any specific penalty that would result in schools losing research or other education grants as a result of specific policies.

Tech companies say that it is easier to identify content related to known foreign terrorist organizations such as ISIS and Al Qaeda because of information-sharing with law enforcement and industry-wide efforts, such as the Global Internet Forum to Counter Terrorism, a group formed by YouTube, Facebook, Microsoft, and Twitter in 2017.

On Monday, for example, YouTube said on its Twitter account that it was harder for the company to stop the video of the shootings in Christchurch than to remove copyrighted content or ISIS-related content because YouTube’s tools for content moderation rely on “reference files to work effectively.” Movie studios and record labels provide reference files in advance and, “many violent extremist groups, like ISIS, use common footage and imagery,” YouTube wrote.

The cycle is self-reinforcing: The companies collect more data on what ISIS content looks like based on law enforcement’s myopic and under-inclusive views, and then this skewed data is fed to surveillance systems, Bloch-Wehba says. Meanwhile, consumers don’t have enough visibility in the process to know whether these tools are proportionate to the threat, whether they filter too much content, or whether they discriminate against certain groups, she says.

Two mystery litigants citing privacy concerns are making a last-ditch bid to keep secret some details in a lawsuit stemming from wealthy financier Jeffrey Epstein’s history of paying underage girls for sex.

Just prior to a court-imposed deadline Tuesday, two anonymous individuals surfaced to object to the unsealing of a key lower-court ruling in the case, as well as various submissions by the parties.

Both people filed their complaints in the New York-based 2nd Circuit Court of Appeals, which is overseeing the case. The two people said they could face unwarranted speculation and embarrassment if the court makes public records from the suit, in which Virginia Giuffre, an alleged Epstein victim, accused longtime Epstein friend Ghislaine Maxwell of engaging in sex trafficking by facilitating his sexual encounters with teenage girls. Maxwell has denied the charges.

Rescue teams in Mozambique are struggling to reach the thousands of people stranded on roofs and in trees and urgently need more helicopters and boats as post-cyclone flood waters continue to rise.

Rescue workers, military personnel and volunteers are rushing to save thousands of Mozambicans before flood levels rise further, but with four helicopters, a handful of boats and extremely difficult conditions, have only been able to save about 413 so far.

“I don’t even know if we’ve made a dent. There are just so many people. The scale is huge. We’re busy doing the best we can,” said Travis Trower from Rescue South Africa, adding that a lot of people had been washed away but those still alive, whom he had seen from helicopter flights, were in a very bad state.

More than 400 sq kilometres (150 sq miles) in the region are flooded, according to satellite images taken by the EU, and in some places the water is six metres (19ft) deep. At least 600,000 people are affected, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA), ranging from those whose lives are in immediate danger to those who need other kinds of aid.